腹腔镜与传统开腹结直肠癌根治术术后并发症发生情况的比较分析

Comparison of postoperative complications of laparoscopic and open colorectal cancer radical resection

目的:比较腹腔镜结直肠癌根治手术与传统的开腹手术术后并发症的发生情况,为两种术式的选择提供参考。方法:回顾分析286例实施结直肠癌根治术的患者,按照手术方式的不同分为腹腔镜组(139例)和开腹组(147例)。腹腔镜组患者给予实施腹腔镜结直肠癌根治手术治疗;开腹组患者给予传统开腹手术治疗。比较两组患者术中、术后并发症的发生情况、手术实施情况及随访1年的预后情况。结果:腹腔镜组和开腹组患者术中并发症的总发生率分别是4.32%和7.48%,两者间差异不存在统计学意义(P>0.05);术后并发症发生率分别为9.35%和16.33%,差异具有统计学意义(P<0.05);一年后随访,腹腔镜组和开腹组患者的存活率分别为87.88%和80.88%,差异不具有统计学意义(P>0.05)。结论:腹腔镜结直肠癌根治手术与传统的开腹手术相比较具有相同的疗效,同时具有手术创口小、出血量少、术后排气时间短以及术后并发症发生概率小的特点。虽然由于腹腔镜的特殊性,治疗效果与医师手术技能操作水平密切相关,但它仍不失为一种更为理想的手术方法。

Objective： To compare postoperative complications between laparoscope and open colorectal cancer radical resection,and provide a reference for the choice of the two surgical options. Methods： 286 patients with colorectal cancers and suffered from the radical resections were selected and divided into laparoscope group（ n = 139） and open surgery group（ n = 147） according to the operation approaches. The laparoscope group was given the laparoscopic colorectal cancer radical resection,while the open surgery group accepted the traditional open surgery. The intraoperative and postoperative complications,surgery implementation situations,and prognosis conditions at one-year follow-up of the two groups were compared. Results： The overall incidences of the intraoperative complications of laparoscope group and open surgery group were 4.32% and 7.48%,and the difference was not statistically significant（ P〈0.05）; the postoperative complication rates were 9.35% and 16.33%,and the difference was statistically significant（ P〈0.05）. At the one-year follow-up,the survival rate of the laparoscope group and open surgery group were 87.88% and 80.88%,and the difference was not statistically significant（ P〈0.05）. Conclusions： Compared with the traditional open surgery,the laparoscopic surgery for colorectal cancer not only has the same effect,but also has characteristics of a small surgical wound,less bleeding,shorter postoperative exhaust time and less postoperative complications. Due to the particularity of laparoscope,the treatment effect is closely related to the surgical skills of the operating physician,but after all,it is a more preferable surgical method.